Cardiac Rehabilitation: Monitoring Your Body's Response to Exercise

Topic Overview

There are several ways to measure your body's responses to exercise
and other lifestyle changes. You may want to keep track of the following
measurements during your exercise sessions at cardiac rehab and at home.

Target heart rate

Your target heart rate can guide you to how hard you need to
exercise so you can get the most aerobic benefit from your workout.

At the beginning of your
rehab, the staff may give you a target heart rate goal to start with. You can use your target heart rate to know how hard you need to exercise
to gain the most aerobic benefit from your workout. You will
probably exercise at the lower end of your target heart rate. As you progress
through the phases of cardiac rehab and you stay more active, you may exercise
harder (at the upper end of your target heart rate range).

Rating of perceived exertion

Rating of perceived exertion (RPE) is a valuable and reliable
indicator in monitoring your exercise tolerance. It is usually used as part of
an organized cardiac rehab program. It is probably most useful to first learn
about RPE with a health professional, such as an exercise physiologist or
trainer. And then you may be able to use it when you exercise on your own.
During exercise, you will want to monitor for and report any angina symptoms, such as chest pain or pressure, to your
doctor.

The RPE is a means of determining how hard you are exerting
yourself, including physiological (how hard you are breathing, how fast your
heart is beating) and muscular strain (how much you feel the exertion in your
muscles). The scale measures your answer to the question: "How hard do you feel
the exercise is?" The scale goes from 6 to 20.

RPE scale

Rating number

Perceived exertion

6

Very, very light

7

8

Very light

9

10

Light

11

12

Somewhat hard

13

14

Hard

15

16

Very hard

17

18

19

Very, very hard

20

Blood pressure

If you are in a supervised cardiac rehab program, your blood
pressure (BP) will also be monitored in addition to HR and RPE. You may want to
be aware of your BP during exercise that you do by yourself. You should expect
a gradual increase in your systolic BP (the first number), while your diastolic
BP (the second number) should show very little change. If this does not happen,
consider any medicines you may be taking that could affect your BP and/or call
your doctor.

Angina

Angina symptoms are caused by your heart
muscle not getting enough blood flow (myocardial ischemia). Your angina may feel like chest pain or discomfort. But you might feel it in other parts of your body. In any case, note if
increased effort leads to any symptoms that can be relieved by rest or
nitroglycerin.

For some people with heart problems, angina always occurs during
activity. And these people must monitor the severity of the pain or stop doing
the activity. Other people with heart problems rarely or never have angina.
Either way, it is important that you recognize angina and know what is usual
for you.

Unless your doctor has specifically told you differently, you
should stop exercising when you feel angina symptoms. Talk to your doctor
about when you should call about angina symptoms. There are also medicines
your doctor can suggest that you may be able to carry with you to treat your
angina.

Shortness of breath

If you have difficulty breathing during exercise, your heart may be
having trouble keeping up with the intensity of your exercise. This difficulty
breathing or shortness of breath is called dyspnea. The dyspnea rating scale
will help you identify how difficult your breathing has become.

Your level of dyspnea during exercise will vary depending upon your
cardiac history and current health status. Your health professionals'
recommendations for an acceptable level of dyspnea will also vary.

Dyspnea rating scale

Rating number

Amount of dyspnea

0

No dyspnea

1

Mild, noticeable

2

Mild, some difficulty

3

Moderate difficulty, but can continue

4

Severe difficulty, cannot continue

By monitoring your level of dyspnea, you can find out the level of
exercise intensity that is most appropriate for you. Usually, you want to keep
your dyspnea level during exercise lower than a level 3. Report to your doctor if and when you experience any abnormal shortness of breath.

Recording measurements

An exercise diary is an excellent way to keep track of your current
aerobic level as well as identify improvement. With each note you should record
the time, distance, and mode of activity. Include any additional information
such as weather conditions, clothing, specific terrain, time of day, and
overall feeling.

A sample exercise diary

Date

Activity

Time

Comments

3/15/2010

Walking

25 minutes

Went approximately 1.5 miles. Weather was a little
windy so I wore a sweater. Stayed on the footpath. Overall it felt good with no
pain. I did 10 minutes of stretching when I got home.

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